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Author
Topic: Dayummmm Syphilis (Read 69734 times)

So, I went for my regular labs on Tuesday, June 21st which included my yearly RPR for syphilis. I also had to go on Thursday for Quantiferion gold TB test (as it is only drawn by the lab on certain days).... After going out to South Beach last night for a few drinks, I came home to find an envelope taped to my door that was marked "Confidential." I open the envelope and find a notice that I have to contact the Department of Health..... so, I am thinking, shit, either the syphilis that I have been treated for twice before (once about a year prior to infection) and then once right when I was diagnosed (a recurrence - which doc states can happen with seroconversion for persons who have had a recent case) or I'm thinking it could be TB.

I send my doctor an email - she is great and responded back to me today..... She says my syphilis RPR came back positive. It always has shown some level however, it has remained acceptable. But, now it appears to have come back. So, she will be moving my follow up appointment to review my labs up from July 11 to this Monday (June 27).... she said we will discuss and plan next steps ---- which, because this is my third occurrence, may involve a lumbar puncture to see if it is neurosyphilis. If it is, there would be the 10 day hospitalization to treat. If it is a lower level recurrence or a new infection - and not neurosyphilis (or if she doesn't order a LP) then I will receive my first of three rounds of double cheek cement butt shots on Monday.

Oh the joys of trying to rid oneself of syphilis when HIV positive....

Did she tell you the actual RPR titre? If it's 1/1 or even 1/2 you might get away with a normal course of treatment. Anything above 1/4 is a problem.

But expect to have that LP and if it's positive then an IV infusion is a certainty.

Love,

MtD

I will find out the titer on Monday - unless she share with me via email or if my labs get posted online - but that probably wont occur til Monday.

The only way it could be a new infection is from this one itty bitty incident when I decided to join a friend after a night out and we went to the luxurious bookstore down the road --- I was only supposed to be getting a little bit of oral satisfaction through the elegantly designed glory hole; however, the anonymous troll on the other side of the wall pulled a bait and switch and moved me from enjoying oral satisfaction to converting this hardcore bottom - albeit only for this encounter - to a full blown top (I thought I could have more trust in the anonymous troll )--- but I digress...

It is actually seeming like it is a recurrence and an unacceptable elevation in the titer, thus the reason that the bells were rung over at the health department --- I am even more of a biohazard than I already was at this point - so, I will probably have to have the LP.... I don't know how well I will handle laying on my side with a large needle shoved inside of me ----now, laying on my back with a large ------- oh, never mind, that is what got me in this mess in the first place

"I have tried hard--but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else."

Booth-queening is so déclassé -- the kool kids throw on some soccer socks and order in!

We're old school / vintage. Bookshops, bathhouses, bushes in the park at dusk, and mall restrooms lead to more memorable tricks.

Now, truck-stops? Nevah evah.

Logged

"I have tried hard--but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else."

Booth-queening is so déclassé -- the kool kids throw on some soccer socks and order in!

What can I say - I live in North Miami - we aren't as classy as those queens in Fort Lauderdale And, since I have moved down this way - I don't even own a pair of soccer socks, I did however order in this evening - a Philly Cheesesteak loaded.... there go my triglycerides, in addition to the syphilis, in addition to the sleep apnea, in addtion to the CPOD, oh, and did I mention I have HIV? Geesh....

We're old school / vintage. Bookshops, bathhouses, bushes in the park at dusk, and mall restrooms lead to more memorable tricks.

Now, truck-stops? Nevah evah.

Do we even have truck stops down here Rev?

Plenty of bookstores (one about 5 blocks from me), Haulover after dark, bushes at the gay beach in Lauderdale, in addition to mall restrooms, gotta include the restrooms at the local colleges (although some of the younger students have that sweet beer smelling breath)

Plenty of bookstores (one about 5 blocks from me), Haulover after dark, bushes at the gay beach in Lauderdale, in addition to mall restrooms, gotta include the restrooms at the local colleges (although some of the younger students have that sweet beer smelling breath)

I think the truckstops in Our state are somewhere near the more rednecky areas (as in any place north of WPB).

Most bookshops in my part of town have gone the way of the LP. Happy Books on US1 used to be a happenin' joint --especially on the weekends. Nowadays it's the same three creepy queens and some bitter fat man behind the counter.

Remember the golden era of Flamingo Park? I saw one too many South Beach beauties riding it cowboy style back in my barhopping days, long before Truvada was used as an alternative to condom usage.

Now, college bathrooms --especially the one at my school-- are still gay rendezvous locations. Lots of peepee comparison going on between athletes and geeks after 7pm.

Logged

"I have tried hard--but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else."

Ive changed my ways and now now think pre-gay marriage sex is of the devil and probably makes the baby Jebus cry . Fortunately I was raised Catholic so if I fall into sinful sex I can mutter a few ole hell yes Mary during the act and save myself .

The only way it could be a new infection is from this one itty bitty incident when I decided to join a friend after a night out and we went to the luxurious bookstore down the road --- I was only supposed to be getting a little bit of oral satisfaction through the elegantly designed glory hole; however, the anonymous troll on the other side of the wall pulled a bait and switch and moved me from enjoying oral satisfaction to converting this hardcore bottom - albeit only for this encounter - to a full blown top (I thought I could have more trust in the anonymous troll )--- but I digress...

Oh stop digressing lying, bitch. We all know you got it from a toilet seat in the basement of your local MegaChurch.

Sorry about the cement shots. Maybe you should just invest in a cement mixer and do your own shots - it would save you money in the long run.

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

So, I got an appointment for today with my ID doc - I will be seeing her @ 3:30 and we will see whats up.... I also left a message on the cell phone of the Dept. of Health worker who left the tapped envelope marked confidential on my door in a widely publicly accessible apartment building telling her how inappropriate that was to do - and then not to return two phone calls I have left her on top of that... next step, after seeing the doc is to make sure that the Director of the Department of Health is aware of how the notification was done.

... Dept. of Health worker who left the tapped envelope marked confidential on my door...

I had that same 'pleasure', but mine was taped to the front door of our house. It could have easily blown off and out into the yard and disappeared in the hands of a nosy passerby. I also complained about this. I'd think it would be more appropriate to try Ole Reliable, the USPS, first and then resort to such methods if that failed.

Dont mean to be too much off topic, but what is the health department posting on all your doors? Is it just a confirmation that you received your diagnosis from the Dr? Seems like overkill. When I tested positive the health department called me, asked me like 2 questions and that was it. No doorknob hangers.

@ bug: they do the notiifications in person or via the letter on the door to try to increase follow up and get people treated. I actuallly called the worker's supervisor today and called the Bureau Chief in Tallahassee and talked with both of them and let them know of the flaws in their system. They seemed like they will address it --- we'll see....

In regards to my visit to my doctor - my titer was 1:8 which makes it seem like it is not a new infection but a recurrence of the old infection. Previous titers were 1:4 and 1:2, respectively.

She was going to do the "cement butt shot" treatment starting today - but we talked about it and decided instead that I will go at the end of July and have the RPR done again - if it stays the same (1: 8 ) or goes up then she will order the lumbar puncture - because that will be a good indication that it is neurosyphilis. It didn't make sense to get the treatment started today and have it temporarily lower the titer, only to have it go back up again in a year.... we both agreed this would be the best route to go for now.

On the plus side, my CD4 went up to 802 (my highest numbers ever) and percentage fell to 38%.

On the bad side - my triglycerides went up to 391 from 280 on the last draw ---- so, she wants me to be more adherent to my Lopid medication and see a nutritionist to adjust my diet....

So the saga contines....all-in-all it could be worse and I am grateful to have a super doctor who works with me and is a partner with me in my health care.

Edited to fix the smiley face with sunglasses that decided to invade my titer reading of 1: 8

On the bad side - my triglycerides went up to 391 from 280 on the last draw ---- so, she wants me to be more adherent to my Lopid medication

C'mon hooker. Why are you skipping that tiny pill? Tsk, tsk...

Logged

"I have tried hard--but life is difficult, and I am a very useless person. I can hardly be said to have an independent existence. I was just a screw or a cog in the great machine I called life, and when I dropped out of it I found I was of no use anywhere else."

I really have no excuse Rev -I have no problem with the once a day Atripla - but when it comes to the twice a day Lopid, I get lazy about it. But, I have to make it a priority to get on track. Tonight I will take it with my Atripla and then take tomorrow at 11 am and so on and so on....

ok, this may sound simplistic , but how do you know you have syphillis? My dorctor tests me ever 4 months i guess i've been lucky, but is there any symptom one should look for? just curious.

mike

Syphilis can be diagnosed in a few ways. The best way is by blood test. In fact you usually need two different blood tests, a specific treponemal serology like TPHA or FTS-Abs and a non-specific test like VDRL or RPR.

The first one determines if you been exposed to the syphilis bacteria, like an HIV antibody test can tell you if you been exposed to HIV. The second determines how serious the infection is. Think of it as being like a viral load test.

It is customary to do both together, though this doesn't always happen. Some doctors just do the non-specific test. The problem with that approach is that things other than syphilis can trigger a false positive and lead to people being treated when they don't need to be.

The window period for syphilis testing is 3 months.

Other ways of diagnosing syphilis include carefully observing symptoms in a patient. The first stage of syphilis always presents as a small, odd looking sore called a chancre. The chancre is quite distinctive and is completely painless. Secretions from the chancre can be taken and examined under a special microscope, called a "dark field microscope", to see if the syphilis bacteria is present. This stage occurs 7-10 days after initial infection.

The chancre is highly infectious. Because the chancre is painless, it can often be missed if it's inside your body (like in the rectum or somewhere similar).

The secondary stage usually occurs a few months to a couple of years after the primary phase. It's characterised by fevers and a rather horrid rash on the palms of the hands and the soles of the feet. Other flat lesions can appear on the body. You this stage is also contagious.

Tertiary syphilis usually occurs many years after the secondary stage (though it can appear much earlier in immunocompromised people) and is the most serious phase. This is when people develop the really horrible things like general paresis of the insane, tabes dorsalis, gummas and caries sicca amongst other beastly things. Symptoms of tertiary syphilis include psychosis and personality changes, dementia, peripheral neuropathy, blindness etc. It can also cause havoc with your heart, lungs, liver and other squishy bits.

The problem with late stage syphilis is that it can be mistaken for many other things. The damage caused at this stage is (usually) permanent but further damage can be arrested with penicillin treatment.

So on balance, routine blood testing following unprotected sexual contact (including oral sex) with casual partners is the way to go.

Phil,If you do have to have the LP done, PLEASE plan to be off work for two days after to lay down and take it easy..I was up and about the very next day and developed the worst headache I have ever had...It actually brought me to a fetal position and made me cry..Drink plenty of caffeine too..The procedure itself was painless...but the spinal headache..just awful..and that's because I tried to be superman right after it

"...health will finally be seen not as a blessing to be wished for, but as a human right to be fought for." Kofi Annan

Nymphomaniac: a woman as obsessed with sex as an average man. Mignon McLaughlin

HIV is certainly character-building. It's made me see all of the shallow things we cling to, like ego and vanity. Of course, I'd rather have a few more T-cells and a little less character. Randy Shilts

Phil,If you do have to have the LP done, PLEASE plan to be off work for two days after to lay down and take it easy..I was up and about the very next day and developed the worst headache I have ever had...It actually brought me to a fetal position and made me cry..Drink plenty of caffeine too..The procedure itself was painless...but the spinal headache..just awful..and that's because I tried to be superman right after it

Thanks for the tip and support Ac -I won't know whether or not it is oging to happen until August 8th - if it does, then it should be shortly after that date.

@ bug: they do the notiifications in person or via the letter on the door to try to increase follow up and get people treated. I actuallly called the worker's supervisor today and called the Bureau Chief in Tallahassee and talked with both of them and let them know of the flaws in their system. They seemed like they will address it --- we'll see....

In regards to my visit to my doctor - my titer was 1:8 which makes it seem like it is not a new infection but a recurrence of the old infection. Previous titers were 1:4 and 1:2, respectively.

She was going to do the "cement butt shot" treatment starting today - but we talked about it and decided instead that I will go at the end of July and have the RPR done again - if it stays the same (1: 8 ) or goes up then she will order the lumbar puncture - because that will be a good indication that it is neurosyphilis. It didn't make sense to get the treatment started today and have it temporarily lower the titer, only to have it go back up again in a year.... we both agreed this would be the best route to go for now.

On the plus side, my CD4 went up to 802 (my highest numbers ever) and percentage fell to 38%.

On the bad side - my triglycerides went up to 391 from 280 on the last draw ---- so, she wants me to be more adherent to my Lopid medication and see a nutritionist to adjust my diet....

So the saga contines....all-in-all it could be worse and I am grateful to have a super doctor who works with me and is a partner with me in my health care.

Edited to fix the smiley face with sunglasses that decided to invade my titer reading of 1: 8

Since we're on this subject. Is a titer of 1:128 extremely high? I've already received the three butt shots. But these measurements are confusing me.

Was the 1:128 titer after your treatment? If so, how long after the treatment? With positive people it can take longer for the titer to go down --- your doc should be checking it every three months until it gets to acceptable levels --- my doc told me anything greater than 1:4 sets off the alarms. It should fall from 1:128 to 1:64, 1:32: 1:16: 1:8; 1:4.... as long as they are seeing a downward trend in it then everything is usually considered in order...

In my case, mine had fallen to 1:2 from a prevous infection than a recurrence that happened at seroconversion -- but then it went up to 1:4 and the latest was 1:8 --- and the alarms went off. So, when I get labs done the end of this month and get the results on 8/8 if it hasn't went down or goes up then doc will order the LP.

So one part of X to 128 parts of Y is a much higher ratio than one part X to 4 parts Y.

Thanks. Last year I tested negative for it upon finding out about my HIV status. The lesion/small rash didn't appear on my "situation" until Jan/Feb. I happened to have my very first sexual encounter after my diagnoses until December, so I'm assuming that was the cause. I tested positive for Syphilis in late Feb. That's when they found out my titer was 1:128.

So my next question is, is it normal for it to be high for first occurances? I received 4 butt injections. The first time I just got once, because according to the "new" guidelines, that's all that was required, but then I called my ID doctor who said I should have gotten three. And since I didn't get the 2nd one until 2-3 weeks later, I had to restart my entire course of treatment over. Sucks right? My PCP said that I received well over the required amount of treatment and at that time all of the lesions went away instantly. But one thing I've noticed about antibiotics is to NEVER drink anything carbonated or with sugar as it can cause some UTI issues. Is this normal? Urgh! My doctor told me I should be fine, and that I am just worrying too much. My last CD4 count was 807 and I'm UD. I go in for my new blood work this weekend.

hi, I'm sorry you're going through this Phil. It's not just people with HIV. My Neg. husband was treated for a positive RPR test 20 years ago, never had any symptoms. Ten years later, his titer went up again & he was given Cipro but it didn't agree with his guts. so he got a shot. The doc was my internist/ID doctor. Six to 12 months later his titer went back up again & this time he got a series of 3 shots.

That was 10 years ago & it hasn't come back. Best of luck with your treatment!Hugs, deibster